【摘要】：目的：研究老年女性骨質(zhì)疏松癥合并髖關(guān)節(jié)病患者行全髖關(guān)節(jié)置換術(shù)后急性期內(nèi)應(yīng)用唑來(lái)膦酸的療效及安全性。方法：選擇2009年1月至2010年1月因髖部骨折或股骨頭無(wú)菌性壞死而住院接受全髖關(guān)節(jié)(非骨水泥型假體)置換術(shù)的老年女性患者,根據(jù)骨密度(BMD)檢測(cè)結(jié)果選取骨質(zhì)疏松癥患者148例,隨機(jī)分為治療組和對(duì)照組,2組患者手術(shù)后均接受鈣劑和骨化三醇治療,治療組于術(shù)后1～2周給予唑來(lái)膦酸5mg靜脈滴注,以后每年給藥1次,連續(xù)3年,對(duì)照組在治療組用藥同期給予相同體積的0.9%氯化鈉注射液。每年復(fù)查并記錄腰椎及健側(cè)髖部骨密度變化,觀察術(shù)后3年內(nèi)假體周圍骨折及假體是否有無(wú)菌性松動(dòng)。結(jié)果：連續(xù)治療3年后治療組骨密度較用藥前提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組用藥前后骨密度差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后3年內(nèi)治療組假體周圍骨折及假體無(wú)菌性松動(dòng)發(fā)生的例數(shù)均低于對(duì)照組。2組用藥后不良反應(yīng)發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：骨質(zhì)疏松患者行關(guān)節(jié)置換術(shù)后急性期內(nèi)使用唑來(lái)膦酸安全有效,可提高骨密度,且可能減少假體周圍骨折和假體松動(dòng)的發(fā)生。
[Abstract]:Objective: to study the efficacy and safety of zoledronic acid in elderly female patients with osteoporosis complicated with hip arthropathy after total hip arthroplasty. Methods: from January 2009 to January 2010, elderly female patients who underwent total hip arthroplasty due to hip fracture or aseptic necrosis of the femoral head were selected. According to the results of bone mineral density (BMD), 148 patients with osteoporosis were randomly divided into treatment group and control group. The patients in both groups were treated with calcium and ossified triol after operation. The treatment group was given zoledronic acid 5mg intravenously at 1 and 2 weeks after operation, and then once a year for 3 years. The control group was given 0.9% sodium chloride injection of the same volume at the same time. The changes of bone mineral density (bone mineral density) of lumbar vertebrae and healthy hip were reviewed and recorded every year to observe the fracture around the prosthesis and aseptic loosening within 3 years after operation. Results: after 3 years of continuous treatment, the bone mineral density of the treatment group was significantly higher than that before treatment, the difference was statistically significant (P 0.05), but there was no significant difference in the bone mineral density of the control group before and after treatment (P 0.05). Within 3 years after operation, the number of cases of periprosthetic fracture and aseptic loosening in the treatment group was lower than that in the control group. There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: zoledronic acid is safe and effective in patients with osteoporosis after joint replacement. Zoledronic acid can increase bone mineral density and reduce the occurrence of fracture and loosening around the prosthesis.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.4
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本文編號(hào)：2473696